Your phone buzzes with a notification: Do you have a fever or a cough? Is it hard to breathe?
Some people who signed up for pilot programs in San Francisco; Danbury, Conn.; and throughout Arkansas started getting automated messages like these every day, and more of us may soon join them.
The questions—which can appear in a text message, an email, or an automated phone call—are designed to help public health officials monitor people known to be at risk of contracting COVID-19 and those who already have it.
In April, 2020 San Francisco began using CommCare, a system developed by Boston-area software company Dimagi, to automatically ask patients about their symptoms. And Arkansas deployed a similar system called Sara Alert, from Mitre, a research nonprofit funded by the federal government.
These trials may provide a glimpse at the coming new normal in the U.S., as the country tries to rein in the pandemic and restart the economy without causing massive new waves of infection. It's important that we hear these stories.
According to Mitre.org: Sara Alert™ is a standards-based, open source tool that automates the process of public health monitoring and reporting of individuals exposed to or infected with COVID-19 or any infectious disease. It was developed by public health experts for public health. Sara Alert™ is available in the public domain, free of charge, to public health agencies. As an open source tool, Sara Alert™ is available for public and private use and is easily integrated into other tools.
In Wilkes-Barre, Pennsylvania experts have stressed the importance of testing and contact tracing to reduce the spread of COVID-19, and employees of the city health department have the latter covered.
Three staff nurses with the city health department have investigated more than 500 cases of COVID-19 in the city since the start of the coronavirus pandemic, and those investigations included tracing the close contacts of the city residents who tested positive.
Wilkes-Barre is one of only 10 cities in the state with its own health department. The state Department of Health is responsible for investigating COVID-19 cases and conducting contact tracing in all of the state’s other 2,550 municipalities.
During an interview in a Department of Health trailer following a back-to-school immunization clinic on Thursday, community health nurse Kady Luchetti and Associate Director of Personal Health Delphine Torbik explained how they did it and how prepared they are for another possible wave of cases as students return to school.
Luchetti said they averaged 40 to 50 case investigations per week. Torbik said they have conducted contact tracing prior to the coronavirus pandemic for cases of tuberculosis and some other communicable diseases, so it was not an entirely new experience. The purpose now, Torbik said, is to mitigate the spread of the highly communicable virus by informing anyone who had close contact (within 6 feet for at least 15 minutes) with someone who tested positive for the virus that they did so and that they must self-quarantine for 14 days and monitor themselves for symptoms, as well as recommend they be tested for the virus themselves.
“But for COVID, it’s been a challenge getting people to give us the information, more than it would be for tuberculosis, and also sticking to the guidance and recommendations, Luchetti said. “Positive cases, they’re willing to give you the household names; they’re easy. Those who they either work with or at a function with are a little more hesitant in giving those names,” Torbik said.
“They don’t want someone who they really don’t know to know that they have it.”Torbik said they do not tell the close contacts the name of the person who exposed them to the virus.
“Could they figure that out? Absolutely, they could probably figure that out. And I think that’s an issue, they just want to keep it private,” Torbik said.Luchetti said it depends on whether or not the person sees COVID “as a serious risk to others. I think those people are usually more motivated to help us control the spread,” she said.
Torbik said that people have been cooperative “for the most part,” more so than in larger cities, based on what they’ve heard from colleagues.
One of the unfortunate things they experience is dealing with contacts who test negative and stop quarantining before the 14 days are up, Luchetti said.Torbik said that in addition to her, Luchetti and nurse Nicole Amos, who interview city residents who test positive for anywhere from 30 to 60 minutes, there are eight health care professionals such as retired doctors and nurses who volunteer to assist with contact tracing when needed.
Alexa Endler, a health care professional with King’s College, also has assisted the city with contact tracing during the summer. King’s now has it’s own contact tracing program for students and employees and has become a subdivision of the city health department.
The city health department remains responsible for investigating and contact tracing for Wilkes University, which has one contact tracer on staff.
Contact tracers do not use anyone’s cellphone to track them if they are supposed to be in self-quarantine.
They can use a cellphone to sign up for the SARA Alert system, which allows them to receive a web link via text message to report to the health department if they have become symptomatic while under self-quarantine, Torbik said.
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